Oracle Blog

Thoughts from a software engineer

Wednesday Dec 23, 2009

This was a phenomenal book that changed the way I looked at every doctor's visit I've ever had, along with questioning at least one diagnosis from my past.

Groopman told story after story about how once one doctor gives you a diagnosis, most other doctors will shut down their "cognitive reasoning" and never question that diagnosis and will keep trying to treat something you may not have. In some stories, this resulted in the death of a patient. He also talks about how physician lore and influence from drug and device companies perpetuate incorrect diagnoses and treatments.

For a personal example of a bad diagnosis sticking, I was diagnosed with carpel tunnel syndrome by a nurse practitioner who referred me to an orthopedic surgeon, who confirmed the diagnosis and was ready to operate. I then was lucky to meet my friend's cousin, a Harvard Med student, who within moments said "you don't even have the right symptoms for carpel tunnel - you have a pinched nerve in your neck and any surgery to your wrist would just cause you more pain and discomfort". My problem was corrected by a series of chiropractic adjustments - no surgery and now I'm pain free (and have been for years).

One poignant set of examples in the book that really stuck with me was about spinal fusion surgeries - these are very common and are well reimbursed by insurance companies, yet there is little evidence that they cure low back and extremity pain. There is little follow up done by the actual surgeons to see how the procedure impacted quality of life, and when follow up is done and the patient hasn't improved, they are simply told "well, you're one of the people this treatment doesn't help". Basically, if you don't have a spinal tumor or an actual broken back, back surgery probably won't help and will likely make things worse!

Groopman keeps things real by even referencing his own mistakes.

This book isn't a scary book, but rather one that gets you to think more about your own health and teaches you how to communicate with your doctor to help them keep out of the cognitive traps and really question what \*else\* could be wrong with you.

It is a must read for everyone! Really!

Thank you, Stormy, for recommending this. I wish I had read it years before!